Foot and Ankle Surgery最新文献

{"title":"The influence of cell and platelet number on clinical outcomes provided by a one-step scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus.","authors":"Luca Berveglieri, Francesca Vannini, Laura Ramponi, Angelo Boffa, Carola Cavallo, Annarita Cenacchi, Giuseppe Filardo, Roberto Buda, Cesare Faldini","doi":"10.1016/j.fas.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.fas.2025.01.014","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate if the numbers of cells and platelets in the bone marrow aspirate concentrate (BMAC) added to a hyaluronic acid membrane influence the clinical outcome up to long-term follow-up in the treatment of osteochondral lesions of the talus (OLTs).</p><p><strong>Methods: </strong>A total of 102 patients with symptomatic OLTs underwent this one-step treatment. Eighty-five patients (53 men, 32 women, age 32.3 ± 10.6 years, lesion size 2.7 ± 1.6 cm²) were prospectively evaluated at baseline and at 2-5-10 years using the AOFAS ankle-hindfoot score, the NRS for pain, and the Tegner score. Satisfaction and failures were documented as well. Laboratory analysis of BMAC was performed for the count of mononucleated cells (MNCs) and platelets.</p><p><strong>Results: </strong>The AOFAS improved from baseline (59.1 ± 13.7) to the final follow-up (82.3 ± 14.9, p < 0.0005). NRS improved from 7.1 ± 1.1 at baseline to 3.9 ± 2.8 at the final follow-up (p < 0.0005). Tegner improved from a pre-op 2.0 median to 3.0 at the final follow-up (p < 0.0005), not reaching the pre-injury level. MNCs and platelets in BMAC were 148.2 ± 54.2 × 10⁹/L and 454.3 ± 277.5 × 10⁹/L, respectively. MNCs correlated with NRS at 2 years (p = 0.018; rho=-0.260). However, MNCs number, as well as platelet number, did not influence the improvement from baseline of the clinical scores at all follow-up evaluations.</p><p><strong>Conclusion: </strong>This study demonstrated, in a large series of patients evaluated up to a long-term follow-up, that the number of MNCs and platelets present in BMAC does not influence the overall clinical outcomes in patients affected by OLTs treated with a one-step hyaluronic acid scaffold implantation augmented with BMAC.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of metatarsal Ewing sarcoma following the resection and intercalary reconstruction with fibular strut allograft: A retrospective case series.","authors":"Khodamorad Jamshidi, Abolfazl Bagherifard, Seyyed Saeed Khabiri, Alireza Mirzaei","doi":"10.1016/j.fas.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, metatarsal Ewing sarcoma (ES) is managed with disarticulation above the tarsometatarsal joint and ray amputation. In this study, we evaluate the outcomes of a less invasive approach in patients with metatarsal ES and good response to neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>Eleven patients with metatarsal ES (mean age: 11.5 ± 3) and complete radiologic response to neoadjuvant chemotherapy who underwent resection and reconstruction with fibular strut allograft were included.</p><p><strong>Results: </strong>At a mean follow-up of 8.5 ± 4 years, the mean Musculoskeletal Tumor Society (MSTS) score of the patients was 29 ± 1.7. Patients with metatarsophalangeal joint fusion had limitations in reactional activities. One patient had a local recurrence. Postoperative complications included wound dehiscence (n = 1), superficial infection (n = 1), and allograft fracture (n = 1). Only one patient required revision surgery.</p><p><strong>Conclusion: </strong>Fibular allograft reconstruction after resection of metatarsal ES can be regarded as a valuable alternative to amputation in patients who respond well to neoadjuvant chemotherapy.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of symptomatic deep vein thrombosis on self-reported function and treatment outcome following an acute Achilles tendon rupture: A register study.","authors":"Jacob S Gandløse, Kristoffer W Barfod, Rikke Hoeffner, Maria Swennergren Hansen, Marianne Christensen, Henrik Riel","doi":"10.1016/j.fas.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Acute Achilles tendon rupture (ATR) is a common injury associated with a high rate of deep vein thrombosis (DVT) during rehabilitation. This study assessed whether DVT affects long-term self-reported function.</p><p><strong>Methods: </strong>Data from the Danish Achilles Tendon Database were used to compare Achilles tendon Total Rupture Scores (ATRS) at 6, 12, and 24 months between patients with and without symptomatic DVT, adjusting for covariates.</p><p><strong>Results: </strong>No significant ATRS difference between DVT and non-DVT groups was observed over time (adjusted mean difference = -0.7, 95 % CI: -4.8-3.3, p = 0.72). However, patients with DVT reported lower ATRS at 24 months (adjusted mean difference = -4.9, 95 % CI: -9.0 to -0.9, p = 0.02).</p><p><strong>Conclusions: </strong>Symptomatic DVT is not significantly associated with self-reported function over time in patients with ATR. However, patients with DVT may experience a recovery plateau, leading to lower long-term function, though the clinical significance is unclear.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual analog scale foot and ankle (VAS-FA): Reliability and validity of the Persian version.","authors":"Hooshmand Zarei, Miad Nosratpour, Seyed Mohammadmisagh Moteshakereh, Mahyar Mahdavi, Amir Sabaghzadeh","doi":"10.1016/j.fas.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.fas.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Our purpose was to evaluate the reliability and validity of the Persian version of the visual analog scale foot and ankle (VAS-FA) among patients with foot and ankle problems and healthy subjects.</p><p><strong>Methods: </strong>The VAS-FA was translated and adapted into Persian (Farsi). Then, 82 participants, including 41 healthy subjects and 41 patients with foot and ankle problems, fulfilled the questionnaire in two sessions. The validity was assessed by correlating VAS-FA with the Persian version of the foot and ankle outcome score (FAOS) and the foot and ankle ability measure (FAAM). Intraclass correlation coefficient (ICC) and Cronbach's α were used to assess test-retest reliability and internal consistency.</p><p><strong>Results: </strong>There was a statistically significant difference between healthy participants and patients regarding the total VAS-FA score and its subscales (P < 0.001). The test-retest reliability was excellent, and the internal consistency was good to excellent. The correlation between the total VAS-FA score and FAAM and FAOS scores was good for the healthy subjects and good to excellent for patients.</p><p><strong>Conclusion: </strong>The Persian version of VAS-FA is valid and reliable.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and reliability of the Simple Achille Value (SAV) in Achilles tendon disorders","authors":"Pierre-Jean Lambrey ,&nbsp;Alexis Thiounn ,&nbsp;Ronny Lopes","doi":"10.1016/j.fas.2024.08.001","DOIUrl":"10.1016/j.fas.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Achilles tendon (AT) disorders significantly impact patient life, necessitating accurate assessment tools. Current methods are often complex and time-consuming. This study aims to validate the Simple Ankle Value (SAV) for AT disorders.</div></div><div><h3>Methods</h3><div>A multicenter study was conducted involving 101 participants, including a surgical, a conservative, and a control group. Participants completed the SAV, VISA-A, and EFAS scores. The study assessed correlations among scores, reliability, responsiveness to change, threshold and ceiling effect and discriminative ability of the SAV.</div></div><div><h3>Results</h3><div>There was a significant strong correlation with the EFAS and a significant moderate to strong correlation with the VISA-A. The score showed excellent reliability (ρ = 0.95, 95 %CI: [0.913; 0.976], p &lt; 0.001). Responsiveness to change was significant between preoperative and postoperative SAV (37.99 ± 25.73 vs 70.86 ± 21.26). The SAV discriminated between patient and controls with no threshold or ceiling effect.</div></div><div><h3>Conclusion</h3><div>The SAV provides a valid, reliable, and responsive method for assessing AT disorders. It offers a simplified and effective alternative to more complex scores.</div></div><div><h3>Study Design</h3><div>Cohort study (Diagnosis); Level of evidence, 2.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Pages 138-142"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical results of ultrasound-guided intra-arterial embolization targeting abnormal neovessels for plantar fasciitis: 66 cases with up to 4 years of follow-up","authors":"Takahide Sasaki ,&nbsp;Masahiko Shibuya ,&nbsp;Koichi Miyazaki ,&nbsp;Masaya Nakata ,&nbsp;Atsuhiko Kawabe ,&nbsp;Takashi Nakasone ,&nbsp;Nobuaki Sakai ,&nbsp;Yuji Okuno","doi":"10.1016/j.fas.2024.07.009","DOIUrl":"10.1016/j.fas.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Plantar fasciitis (PF) is the most common cause of chronic heel pain, affecting young and older patients.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with PF refractory to conservative treatment who underwent intra-arterial embolization of abnormal neovessels. All patients received temporary embolic material through a needle percutaneously inserted into the posterior tibial artery. The numeric rating scale (NRS) pain score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and procedure-related adverse events were evaluated.</div></div><div><h3>Results</h3><div>Between January 2020 and February 2022, 66 patients with PF were treated with intra-arterial embolization without major adverse events. The NRS pain score improved significantly, and the AOFAS score increased from 65.8 pre-treatment to 92.8 at 1 year post-treatment. The treatment effect was maintained until the final follow-up (mean duration: 30.9 months).</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided intraarterial embolization using temporary embolic material may be effective for PF.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Pages 105-110"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Talocalcaneal coalition classifications: A critical analysis review and suggested new classification system with implications for treatment” [Foot Ankle Surg, 30(6) August 2024, pp 450–456]","authors":"Mark S. Myerson ,&nbsp;Enrique Fernández-Rojas ,&nbsp;Manuel Monteagudo ,&nbsp;Víctor Araya-Bonilla ,&nbsp;Emilio Barra-Dinamarca ,&nbsp;Jaime Elgueta-Grillo","doi":"10.1016/j.fas.2024.12.006","DOIUrl":"10.1016/j.fas.2024.12.006","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Page 182"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses","authors":"Dahai Hu ,&nbsp;Hongyan Sun ,&nbsp;Shengli Wang ,&nbsp;Huajun Wang ,&nbsp;Xiaofei Zheng ,&nbsp;Hui Tang ,&nbsp;Huige Hou","doi":"10.1016/j.fas.2024.07.010","DOIUrl":"10.1016/j.fas.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Chronic ankle instability (CAI) is a common and highly disabling condition. Although several studies have evaluated and analyzed prevention and treatment strategies for CAI, an unbiased and systematic synthesis of evidence is required to provide the most powerful and comprehensive evidence-based measures for the its prevention and treatment of CAI. This study aimed to synthesize evidence from the existing literature addressing the treatment and prevention of CAI.</div></div><div><h3>Methods</h3><div>The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant studies from inception to December 12, 2023. Data on effect sizes and corresponding 95 % confidence intervals for selected intervention measures were extracted. Systematic reviews were assessed for quality of included studies using a measurement tool (i.e., “AMSTAR 2”).</div></div><div><h3>Results</h3><div>In total, 37 studies were included, among which 21 (57 %) were of high or moderate quality. Strong evidence suggested that lower weight (<em>P</em> &lt; 0.001), lower body mass index (<em>P</em> = 0.002), and non-stability defects (<em>P</em> = 0.04) significantly reduced the risk of developing CAI. Strong evidence supported exercise and moderate evidence supported manual therapy, acupuncture, and surgery for improving CAI. Additionally, external support plays an active role in the treatment process of CAI.</div></div><div><h3>Conclusion</h3><div>This is the first study synthesizing evidence supporting interventions for the treatment and prevention of CAI. Low body weight and body mass index were effective preventive measures against CAI. Exercise, manual therapy, acupuncture, and surgery can improve ankle function in patients with CAI. Plantar sensory treatment and neuromuscular training may be good therapeutic options for patients with CAI.</div></div><div><h3>Level of evidence</h3><div>Level I</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Pages 111-125"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A finite element analysis","authors":"T.L. Lewis ,&nbsp;H. Mansur ,&nbsp;G.F. Ferreira ,&nbsp;M.V.P. Filho ,&nbsp;L.R. Battaglion ,&nbsp;R. Zambelli ,&nbsp;R. Ray ,&nbsp;G.A. Nunes","doi":"10.1016/j.fas.2024.09.001","DOIUrl":"10.1016/j.fas.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>There are different screw configurations utilised for minimally invasive hallux valgus (HV) deformity despite limited biomechanical data assessing the stability and strength of each construct. We aimed to compare the strength of various screw configurations for minimally invasive HV surgery using finite element analysis (FEA).</div></div><div><h3>Methods</h3><div>A FEA model was developed from a CT of a female with moderate HV deformity. Five screw configurations utilizing one or two bicortical or intramedullary screws were tested. Stress analysis considered osteotomy displacement, maximum and minimum principal stresses, and von Mises stress for both implants and bone for each screw configuration.</div></div><div><h3>Results</h3><div>Fixation with two screws (one bicortical and one intramedullary) demonstrated the lowest values for osteotomy displacement, minimum and maximum total stress, and equivalent von Mises stress on the bone and screws in both loading conditions.</div></div><div><h3>Conclusion</h3><div>The optimal configuration when performing minimally invasive surgery for moderate HV is one bicortical and one intramedullary screw.</div></div><div><h3>Level of evidence</h3><div>Level III</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Pages 160-169"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Méary's angle decoded: 3D analysis of first ray plantarflexion deformity in Charcot-marie-tooth disease","authors":"Max P. Michalski ,&nbsp;Christian L. Blough ,&nbsp;Jae Hwang Song ,&nbsp;Glenn B. Pfeffer","doi":"10.1016/j.fas.2024.08.003","DOIUrl":"10.1016/j.fas.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>The typical cavovarus deformity seen in patients with Charcot-Marie-Tooth (CMT) involves plantarflexion of the first ray. The exact apex of the deformity has never been proven, although it is presumed to be within the medial cuneiform. The aim of this study was to utilize weight-bearing computed tomography (WBCT) to localize and quantify first ray plantarflexion deformity in CMT patients.</div></div><div><h3>Methods</h3><div>WBCTs of 16 CMT patients with lateral Méary’s angle &gt; 20 degrees were compared to controls utilizing semi-automated analysis software. A local coordinate system based on the first metatarsal was used to avoid bias of proximal deformity. The tarsometatarsal angle was subdivided into components (cuneiform-cuneiform joint normal, tarsometatarsal joint and metatarsal-metatarsal joint normal) and compared between CMT and controls. CMT patient’s first, second and third rays were also compared. Means were compared with a 2-sample t test (p &lt; .05).</div></div><div><h3>Results</h3><div>CMT patients had significantly more plantarflexion of the first ray than controls (16.4 versus 8.8 degrees respectively(p &lt; 0.001)). The largest difference of was found at the medial cuneiform with 20.6 degrees of plantarflexion in CMT patients versus 14.8 degrees in controls (p &lt; .0001). There was also approximately 2 degrees of plantarflexion at the TMT joint (p &lt; .001).</div></div><div><h3>Conclusions</h3><div>Plantarflexion deformity in CMT patients is primarily an osseous deformity at the level of the medial cuneiform with a lesser contribution from the tarsometatarsal joint.</div></div><div><h3>Level of evidence</h3><div>III Retrospective comparative study</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 2","pages":"Pages 143-147"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}